Wednesday, March 26, 2014

The Long and Winding Road

This, ladies and gents, is my elbow. That lovely slash there in the middle is my incision, which is still sensitive and painful to the touch even now, close to three months post op. The discoloration around it is the result of the awesomeness that is physical therapy. That would be bruising. Bruising from them man handling the elbow. Bruising from them pushing and pulling on the joint. And if you are looking at it, you might notice that it also looks a little misshapen. That would be the swelling. The swelling that never quite went down after the surgery, and seems to get worse every time I go in for the 90 minute torture session that is physical therapy. The swelling that, no matter how much I ice it, doesn't seem to go away, and that often feels like it's causing my joint to become more stiff the more my physical therapist works on it, not less. Most days I leave physical therapy and I feel like I have less mobility in my arm than I did when I walked in. Lately, if I can use my hand or lift my arm at all afterward, that's a red letter day and I should consider myself damn lucky. It's been about three weeks with lots of pain and little progress, and it's starting to make me both frustrated and impatient.

I know that this is "a process". That the body doesn't heal overnight. I get that. I'm just starting to get worn down by the fact that I keep going in and doing all of this work, going through all of the pain that they inflict on me, and then seeing zero progress from one week to the next. I've tried to embrace my inner bad ass and just grit my teeth through it all, letting them tug at my arm like it's not attached to the rest of me while trying not to wince or grimace or swear too much. The truth of the matter is, it fucking hurts. Like, I know people tell you that PT is painful, but I think your average person going through PT is dealing with something relatively minor, like pulling a muscle in their shoulder, or pain in their hip. I think the ante gets up significantly when you throw in an injury with scar tissue involved. You hear that term a lot, but what you don't realize when you're hearing it is that to get through the whole scar tissue roadblock, you have to fucking tear the tissue. Literally, rip it. Take a moment to imagine how fabulous that feels. What seems to be "special" about my situation is that usually when scar tissue pulls apart or tears, the person stretching you out can feel it happen, because the joint gives a little bit and things loosen up. With mine, it's even more exciting. With mine, you can hear it. There is an audible popping, snapping or ripping noise when they break through my scar tissue. I'm told that's not terribly common. In fact, the first time it happened the physical therapist said "Wow, for me to hear it means we're breaking through some seriously bad tissue". Gee, awesome. Just lucky, I guess. I think it freaked him out though, because after I left he called my surgeon's office to make sure they weren't doing anything that could damage me further. So there's an example of how rare it is. Woo! I'm exceptional!

It also sucks that I can feel my muscles and tendons tugging against the anchors that have been inserted into my bone every time they work on me. I can feel precisely where he anchored each muscle, and I can feel everything pulling against those anchors every single time. It's a disgusting sensation. My big worry is that even after I'm "normal" I'll still be able to feel that. I would prefer not to.

I think the uncertainty of things is what's heightening my anxiety. Sure, I'm told that I should be able to make a full recovery to normal, or at least my surgeon thinks so. I've gotten some skeptical looks from my physical therapist on that front. I've also seen zero progress in weeks, no matter what they do to me. I am starting to worry that it's all a load of crap and I'm going to be one armed for the rest of my life. Then I try to imagine not being able to do normal things that I think of now as "I can't do that until my arm gets better...." becoming a permanent situation. Stupid things, like washing my hair with both hands, or putting on a necklace. Then it's big things like picking up my niece and nephews to hug them. Or if we have our own kids, not being able to properly hold one because of my arm. Not being able to walk Ronan because I can't trust him not to chase a rabbit and pull me over onto my arm. Not being able to hug anyone properly because I can't bend my arm in quite enough. Those are the things that scare me. I'd be better at dealing with the PT if it meant I could be guaranteed to get those things back.

I know the road is supposed to be long, and I'm at the beginning of it, but I keep feeling like I'm already falling behind. Mostly I just want to be back to normal.

1 comment:

As part of my Occupational Therapist shadowing I've observed recently in Hand Therapy. (I wonder if you're being treated by a licensed Hand Therapist which would be an OT or if it's just a regular PT? I don't think PTs get a special certification in Hand Therapy- it's called "Hand Therapy" but it means "upper extremity" so your elbow would count.) In my observations I have seen how much scar tissue influences the mobility and progression in therapy. A few of the patients I saw who had built up scar tissue in their fingers had to have surgery to remove the scar tissue. Maybe they can't do that for you because it's your elbow? Well, and I'm sure anyone would be reluctant to go through more surgery after you've been through so much trauma. From what I've observed it is a long road, like you said. Some patients had been going to therapy for months and still didn't have great mobility. One hand therapist told a patient that full recovery only happens after a year, which is hard to swallow after the doctor tells the patient recovery will take 4-6 weeks. They mean 4-6 weeks until things are "healed" but not til you're back to normal functioning.

Anyway, I'm sure it's frustrating. But you're doing the best you can, doing what they tell you to in therapy is a great achievement in itself with the pain you have. Some people don't do what is asked in sessions, and don't do the homework which makes everything take longer. I certainly hope your injury doesn't have long-term effects. I wonder if you could be referred to a different therapist if you truly feel like it's not progressing? Some therapists are better than others. Heather Archer is an OT who specializes in hand therapy, she may know someone. I would want to look into a licensed hand therapist, an OT who only works on upper extremity injuries since they are specialized. But hopefully you're already working with someone certified.